Definition of Mantoux test Definition of Mantoux test Mantoux test: A skin test for tuberculosis , named for the French physician Charles Mantoux (1877-1947). See: Tuberculin . Last Editorial Review: 6/9/2016 Use the pill finder tool on RxList. Trending on MedicineNet Get the Latest health and medical information delivered direct to your inbox! From ©1996-2017 MedicineNet, Inc. All rights reserved. Terms of Use. MedicineNet does not provide medical advice, diagnosis or treatment. See additional information . Health Categories PPD skin test: MedlinePlus Medical Encyclopedia URL of this page: //medlineplus.gov/ency/article/003839.htm PPD skin test The PPD skin test is a method used to diagnose silent (latent) tuberculosis (TB) infection. PPD stands for purified protein derivative. How the Test is Performed You will need 2 visits to your doctor's office for this test. At the first visit, the health care provider will clean an area of your skin, usually the inside of your forearm. You will get a small shot (injection) that contains PPD.

The needle is gently placed under the top layer of skin, causing a bump (welt) to form. This bump usually goes away in a few hours as the material is absorbed. After 48 to 72 hours, you must return to your provider's office. Your provider will check the area to see if you have had a strong reaction to the test. How to Prepare for the Test There is no special preparation for this test. Tell your provider if you have ever had a positive PPD skin test. If so, you should not have a repeat PPD test, except under unusual circumstances. Tell your provider if you have a medical condition or if you take certain medicines, such as steroids, which can affect your immune system. These situations may lead to inaccurate test results. Tell your provider if you have received the BCG vaccine and if so, when you received it. (This vaccine is only given outside of the United States). How the Test will Feel You will feel a brief sting as the needle is inserted just below the skin surface. Why the Test is Performed This test is done to find out if you have ever come in contact with the bacteria that causes TB. TB is an easily spread (contagious) disease.

It most often affects the lungs. The bacteria can remain inactive (dormant) in the lungs for many years. This situation is called latent TB. Most people in the United States who are infected with the bacteria do not have signs or symptoms of active TB. You are most likely to need this test if you: May have been around someone with TB Work in health care Have a weakened immune system, due to certain medicines or disease (such as cancer or HIV and AIDS) Normal Results A negative reaction usually means you have never been infected with the bacteria that cause TB. With a negative reaction, the skin where you received the PPD test is not swollen, or the swelling is very small. This measurement is different for children, people with HIV, and other high-risk groups. The PPD skin test is not a perfect screening test. A few people infected with the bacteria that cause TB may not have a reaction. Also, diseases or medicines that weaken the immune system may cause a false-negative result. What Abnormal Results Mean An abnormal (positive) result means you have been infected with the bacteria that cause TB. You may need treatment to lower the risk of the disease coming back (reactivation of the disease).

A positive skin test does not mean that a person has active TB. More tests must be done to check whether there is active disease. A small reaction (5 mm of firm swelling at the site) is considered to be positive in people: Who have HIV Who have received an organ transplant Who have a suppressed immune system or are taking steroid therapy (about 15 mg of prednisone per day for 1 month) Who have been in close contact with a person who has active TB Who have changes on a chest x-ray that look like past TB Larger reactions (larger than or equal to 10 mm) are considered positive in: People with a known negative test in the past 2 years People with diabetes, kidney failure, or other conditions that increase their chance of getting active TB Health care workers Injection drug users Immigrants who have moved from a country with a high TB rate in the past 5 years Children under age 4 Infants, children, or adolescents who are exposed to high-risk adults Students and employees of certain group living settings, such as prisons, nursing homes, and homeless shelters In people with no known risks of TB, 15 mm or more of firm swelling at the site indicates a positive reaction.

People who were born outside the United States who have had a vaccine called BCG may have a false-positive test result. Risks There is a very small risk of severe redness and swelling of the arm in people who have had a previous positive PPD test and who have the test again. This reaction can also occur in a few people who have not been tested before. Alternative Names CDC | TB | Fact Sheets - Tuberculosis: General Information Tuberculosis: General Information What is TB? Tuberculosis (TB) is a disease caused by germs that are spread from person to person through the air. TB usually affects the lungs, but it can also affect other parts of the body, such as the brain, the kidneys, or the spine. A person with TB can die if they do not get treatment. What Are the Symptoms of TB? The general symptoms of TB disease include feelings of sickness or weakness, weight loss, fever, and night sweats. The symptoms of TB disease of the lungs also include coughing, chest pain, and the coughing up of blood. Symptoms of TB disease in other parts of the body depend on the area affected. How is TB Spread?

TB germs are put into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. These germs can stay in the air for several hours, depending on the environment. Persons who breathe in the air containing these TB germs can become infected; this is called latent TB infection. What is the Difference Between Latent TB Infection and TB Disease? People with latent TB infection have TB germs in their bodies, but they are not sick because the germs are not active. These people do not have symptoms of TB disease, and they cannot spread the germs to others. However, they may develop TB disease in the future. They are often prescribed treatment to prevent them from developing TB disease. People with TB disease are sick from TB germs that are active, meaning that they are multiplying and destroying tissue in their body. They usually have symptoms of TB disease. People with TB disease of the lungs or throat are capable of spreading germs to others. They are prescribed drugs that can treat TB disease. What Should I Do If I Have Spent Time with Someone with Latent TB Infection? A person with latent TB infection cannot spread germs to other people.

You do not need to be tested if you have spent time with someone with latent TB infection. However, if you have spent time with someone with TB disease or someone with symptoms of TB, you should be tested. What Should I Do if I Have Been Exposed to Someone with TB Disease? People with TB disease are most likely to spread the germs to people they spend time with every day, such as family members or coworkers. If you have been around someone who has TB disease, you should go to your doctor or your local health department for tests. How Do You Get Tested for TB? There are two tests that can be used to help detect TB infection: a skin test or TB blood test. The Mantoux tuberculin skin test is performed by injecting a small amount of fluid (called tuberculin) into the skin in the lower part of the arm. A person given the tuberculin skin test must return within 48 to 72 hours to have a trained health care worker look for a reaction on the arm. The TB blood tests measure how the patient’s immune system reacts to the germs that cause TB. What Does a Positive Test for TB Infection Mean?

A positive test for TB infection only tells that a person has been infected with TB germs. It does not tell whether or not the person has progressed to TB disease. Other tests, such as a chest x-ray and a sample of sputum, are needed to see whether the person has TB disease. What is Bacille Calmette–Guèrin (BCG)? BCG is a vaccine for TB disease. BCG is used in many countries, but it is not generally recommended in the United States. BCG vaccination does not completely prevent people from getting TB. It may also cause a false positive tuberculin skin test. However, persons who have been vaccinated with BCG can be given a tuberculin skin test or TB blood test. Why is Latent TB Infection Treated? If you have latent TB infection but not TB disease, your doctor may want you to take a drug to kill the TB germs and prevent you from developing TB disease. The decision about taking treatment for latent infection will be based on your chances of developing TB disease. Some people are more likely than others to develop TB disease once they have TB infection.

This includes people with HIV infection, people who were recently exposed to someone with TB disease, and people with certain medical conditions. How is TB Disease Treated? TB disease can be treated by taking several drugs for 6 to 12 months. It is very important that people who have TB disease finish the medicine, and take the drugs exactly as prescribed. If they stop taking the drugs too soon, they can become sick again; if they do not take the drugs correctly, the germs that are still alive may become resistant to those drugs. TB that is resistant to drugs is harder and more expensive to treat. In some situations, staff of the local health department meet regularly with patients who have TB to watch them take their medications. This is called directly observed therapy (DOT). DOT helps the patient complete treatment in the least amount of time. Additional Information The tuberculosis (TB) skin test, sometimes called a “Mantoux,” is a simple, harmless way to find out if you have latent TB infection. What is latent TB infection? There are two phases of TB. Both phases can be treated with medicine. When TB germs first enter your body, they cause latent TB infection. Without treatment, latent TB infection can become active TB disease.

Anyone can get TB because it spreads from one person to another through the air. Phase 1 – Latent TB Infection Phase 2 – Active TB Disease TB germs are “asleep” in your body. This phase can last for a very long time – even many years. TB germs are active and spreading. They are damaging tissue in your body. You don’t look or feel sick. Your chest x-ray is usually normal. You usually feel sick. Your doctor will do special tests to find where TB is harming your body. You can’t spread TB to other people. If the TB germs are in your lungs, you can spread TB to other people by coughing, sneezing, talking, or singing. Usually treated by taking one medicine for 9 months. Treated by taking 3 or 4 medicines for at least 6 months. How can I tell if I have latent TB infection? A TB skin test (“Mantoux”) can show if you have latent TB infection. You could have latent TB infection if you have ever spent time close to someone with active TB disease (even if you didn’t know they were sick).

Your health care provider will use a small needle to inject some harmless testing fluid (called “tuberculin”) under the skin on your arm. Your health care provider MUST check your arm 2 or 3 days after the TB skin test, even if your arm looks OK to you. If you have a reaction to the test, it will look like a raised bump. Your health care provider will measure the size of the reaction. If there is a bump, it will go away in a few weeks. How do I take care of my arm after the TB skin test? Don’t cover the spot with a bandage or tape. Be careful not to rub it or scratch it. If the spot itches, put a cold cloth on it. You can wash your arm and dry it gently. Don’t be afraid to be tested. TB can be cured! What if my TB skin test is negative? The test is “negative” if there is no bump (or only a very small bump) at the spot where the fluid was injected. A negative TB skin test usually means that you don’t have TB. In some situations, you may need to have another TB skin test later. What if my TB skin test is positive?

The test is “positive” if there is a bump of a certain size where the fluid was injected. This means you probably have TB germs in your body. Most people with a positive TB skin test have latent TB infection. To be sure, your doctor will examine you and give you a chest x-ray. You may need other tests to see if you have active TB disease. Protect your health and the health of your family - get a TB skin test! To get a TB skin test, contact your doctor or your public health department. You should have a TB skin test if: you have had frequent close contact with someone who has active TB disease, you have lived in a country where many people have TB, you work or live in a nursing home, clinic, hospital, prison, or homeless shelter, or you have HIV infection or certain other health problems. What if I’ve had BCG vaccine? Even if you have had BCG vaccine, you can have a TB skin test. People who have had BCG vaccine still can get latent TB infection and active TB disease. BCG vaccine may help protect young children from getting very sick with TB. This protection goes away as people get older. BCG vaccine sometimes causes a positive TB skin test reaction.

But if you have a positive reaction to the TB skin test, it probably is from TB germs in your body - not from your BCG vaccine. You can have a TB skin test, even if you have had BCG vaccine! Tuberculin, Purified Protein Derivative For Mantoux Test Information from Drugs.com Rx only Description Tuberculin PPD 1 (Mantoux)--Tubersol for intracutaneous (Mantoux) tuberculin testing is available in stabilized solutions bio-equivalent to 5 US units (TU) PPD-S per test dose (0.1 mL) and stabilized solutions diluted to a calculated bio-equivalence of 1 TU and 250 TU strengths per test dose (0.1 mL). Tubersol is prepared by the Aventis Pasteur Limited from a large Master Batch, Connaught Tuberculin (CT68), which has been obtained from a human strain of Mycobacterium tuberculosis grown on a protein-free synthetic medium. The use of a standard preparation derived from a single batch (CT68) has been recommended 2 in order to eliminate batch to batch variation by the same manufacturer.

Tubersol is a sterile isotonic solution of Tuberculin in phosphate buffered saline containing Tween 80 (0.0005%) as a stabilizer. Phenol 0.28% is added as a preservative. 3,4,5 Independent studies conducted by the US Public Health Service in humans have determined the amount of CT68 in stabilized solution necessary to produce bio-equivalency with Tuberculin PPD-S (in phosphate buffer without Tween 80) using 5 US units (TU) Tuberculin PPD-S as the standard. Prior to release, each successive lot is tested for potency in sensitized guinea pigs in comparison with the US Standard Tuberculin PPD-S distributed by the Office of Biologics, Food and Drug Administration, Bethesda, Maryland, USA 6 Clinical Pharmacology Intracutaneous tuberculin testing is an accepted aid in the diagnosis of tuberculosis infection. The reaction to intracutaneously injected tuberculin is a delayed (cellular) hypersensitivity reaction. The reaction which characteristically shows a delayed course, reaching its peak more than 24 hours after administration, consists of induration due to cell infiltration and occasionally vesiculation and necrosis.

Clinically, a delayed hypersensitivity reaction to tuberculin is a manifestation of previous infection with M. tuberculosis or a variety of non-tuberculosis bacteria. In most cases sensitization is induced by natural mycobacterial infection or by vaccination with BCG Vaccine. The sensitization following infection with mycobacteria occurs primarily in the regional lymph nodes. Small lymphocytes (T lymphocytes) proliferate in response to the antigenic stimulus to give rise to specifically sensitized lymphocytes. After several weeks, these lymphocytes enter the blood stream and circulate for long periods of time. Subsequent restimulation of these sensitized lymphocytes with the same or a similar antigen, such as the intradermal injection of tuberculin, evokes a local reaction mediated by these cells. The tuberculin reaction is characterized by the early predominance of mononuclear cells (small and medium sized lymphocytes and monocytes). Only a small proportion of these cells appear to be lymphocytes sensitized to tuberculin. Most cells are brought into the reaction through the release of biologically active substances by sensitized lymphocytes. An increase in vascular permeability leading to erythema and edema also occurs in tuberculin reactions.

Characteristically, delayed hypersensitivity reactions to tuberculin begin at 5 to 6 hours, are maximal at 48 to 72 hours and subside over a period of days. In those who are elderly or those who are being tested for the first time reactions may develop slowly and may not peak until after 72 hours. Immediate hypersensitivity reactions to tuberculin or to constituents of the diluent can also occur. Not all infected persons will have a delayed hypersensitivity reaction to a tuberculin test. A large number of factors has been reported to cause a decreased ability to respond to the tuberculin test in the presence of tuberculous infection including viral infections (measles, mumps, chickenpox), live virus vaccinations (measles, mumps, polio), overwhelming tuberculosis, other bacterial infections, drugs (corticosteroids and many other immunosuppressive agents), and malignancy. 7 Indications and Usage Tubersol is indicated as an aid in the detection of infection with Mycobacterium tuberculosis. For the initial intracutaneous (Mantoux) tuberculin test it is customary to use 5 US units (TU) per test dose of 0.1 mL.

The 1 TU per test dose (0.1 mL) preparation is used for individuals suspected of being highly sensitized since larger initial doses may result in severe skin reactions. The preparation containing 250 TU per test dose (0.1 mL), should be used exclusively for the testing of individuals who fail to react to a previous injection of 5 TU and under no circumstances is it to be used for the initial injection. Contraindications Tubersol should not be administered to known tuberculin positive reactors because of the severity of reactions (eg. vesiculation, ulceration or necrosis) that may occur at the test site in highly sensitive persons. Warnings Tubersol 250 TU per test dose (0.1 mL) is not, under any circumstances, to be used for the initial injection. Avoid injecting Tubersol subcutaneously. If this occurs, no local reaction will develop, but a general febrile reaction and/or acute inflammation around old tuberculosis lesions may occur in highly sensitive individuals. Precautions a) General A separate sterile syringe and needle must be used for each individual injection to prevent the possibility of transmission of viral hepatitis or other infectious agents from one person to another.

The possibility of allergic reactions in individuals sensitive to the components of the product should be borne in mind. Epinephrine Hydrochloride Solution (1:1000) should be readily available for use in case an anaphylactic or acute hypersensitivity reaction occurs. Failure to store and handle Tubersol as recommended will result in a loss of potency and inaccurate test results. b) Information for Patients Reactivity to the test may be depressed or suppressed for as long as 5 to 6 weeks in individuals who have received concurrent or recent immunization with certain virus vaccines (measles, influenza), who have had viral infections (rubeola, influenza, mumps and probably others) or who are receiving corticosteroids or immunosuppressive agents. In those who are elderly or being tested for the first time reactions may develop slowly and may not peak until after 72 hours. Vesiculation, ulceration or necrosis may appear at the test site in highly sensitive persons. Pain, pruritis and discomfort at the site may also occur.

c) Laboratory Tests Since a positive tuberculin reaction (10 mm or more) does not necessarily indicate the presence of active tuberculous disease, individuals showing such positive tuberculin reactions should be subjected to other diagnostic procedures, such as X-ray examination of the chest and microbiological examination of the sputum. In the case of the doubtful tuberculin reactions (5 to 9 mm) to 5 TU, the possibility should not be excluded that the skin sensitivity is due to previous contact with atypical mycobacteria or previous BCG vaccination. In the absence of signs of tuberculous disease, differential diagnosis by means of intracutaneous skin tests with PPD's derived from atypical mycobacteria may be indicated. d) Drug Interactions Reactivity to the test may be depressed or suppressed in individuals who are receiving corticosteroids or immunosuppressive agents. Reactivity to PPD may be temporarily depressed by certain live virus vaccines (measles, mumps, rubella). Therefore, if a tuberculin test is to be performed, it should be administered either before or simultaneously with the injection of measles, mumps and rubella vaccines in combined form or as separate antigens.

e) Carcinogenesis, Mutagenesis, Impairment of Fertility The product is not used for extended treatment over a long period of time. f) Pregnancy Category C (Tuberculin) Animal reproduction studies have not been conducted with Tubersol. It is also not known whether Tubersol can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Tubersol should be given to a pregnant woman only if clearly needed. However, the risk of unrecognized tuberculosis and the close post partum contact between a mother with active disease and an infant leaves the infant in grave danger of tuberculosis and complications such as tuberculous meningitis. Therefore, the prescribing physician will want to consider if the potential benefits outweigh the possible risks for performing the tuberculin test on a pregnant woman or a woman of childbearing age, particularly in certain high risk populations. Adverse Reactions In highly sensitized individuals, strongly positive reactions including vesiculation, ulceration or necrosis may occur at the test site. Cold packs or topical steroid preparations may be employed for symptomatic relief of the associated pain, pruritus and discomfort. Strongly positive reactions may result in scarring at the test site.

Immediate erythematous or other reactions may occur at the injection site. The reason(s) for these infrequent occurrences are presently unknown. Dosage and Administration The Test: The Mantoux test is performed by intracutaneously injecting, with a syringe and needle, 0.1 mL of Tubersol. It is customary to use 5 TU per test dose. The 1 TU per test dose preparation is used for individuals suspected of being highly sensitized since larger initial doses may result in severe skin reactions. The preparation containing 250 TU per test dose should be used exclusively for the testing of individuals who fail to react to a previous injection of 5 TU and under no circumstances is to be used for the initial injection. The result is read 48 to 72 hours after administration and induration only is considered in interpreting the test. Method of Administration: The following procedure is recommended for performing the Mantoux test: The site of the test is the flexor surface of the forearm about 4 inches below the bend of the elbow. The skin of the forearm is first cleansed with alcohol and allowed to dry.

The test dose (0.1 mL) of Tuberculin PPD is administered with a 1 mL syringe calibrated in tenths and fitted with a short, one-half inch, 26 or 27 gauge needle. Disposable sterile syringes and needles may be used. Glass syringes and needles should be sterilized by autoclaving (121°C for 30 minutes), by boiling or by the use of dry heat. Do not sterilize by means of alcohol. The rubber cap of the vial should be wiped with sterile piece of cotton moistened with alcohol and allowed to dry. The needle is then inserted gently through the cap and the required amount of Tuberculin PPD is drawn into the syringe. The point of the needle is inserted into the most superficial layers of the skin with the needle bevel pointing upward. If the intracutaneous injection is performed properly, a definite white bleb will rise at the needle point, about 10 mm ( 3 / 8 ") in diameter. This will disappear within minutes. No dressing is required. In the event of a subcutaneous injection (i.e. no bleb formed), the test should be repeated immediately at another site.

Tubersol is a stabilized solution of Tuberculin PPD. Data indicates that Tubersol will remain stable for at least four weeks when prefilled into syringes and stored between 2°C and 8°C.4 However, in order to avoid possible contamination of the product this practice is not recommended. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solutions and container permit. Interpretation of the Test: The test should be read 48 to 72 hours after administration of Tubersol. Sensitivity is indicated by induration, usually accompanied by erythema. The widest diameter of distinctly palpable induration should be recorded in millimeters (mm). Presence of edema and necrosis should also be recorded. A positive reaction indicates a sensitivity to tuberculin, which may be the result of a previous infection with mycobacteria. This infection, likely due to Mycobacterium tuberculosis, may have occurred years ago or may be of recent origin. Reactions should be interpreted as follows: Positive Reaction: Any palpable induration measuring 15 mm or more is considered a positive reaction in any person.

An induration measuring 10 mm or more is considered positive in recent immigrants (< 5 years) from high-prevalence countries; injection drug users; residents and employees of high-risk congregate settings; mycobacteriology laboratory personnel; persons with clinical conditions that place them at high risk; children < 4 years of age; and infants, children, and adolescents exposed to adults in high-risk categories. An induration measuring 5 mm or more is considered positive in HIV-infected persons; a recent contact of a person with TB disease; persons with fibrotic changes on chest radiograph consistent with prior TB; patients with organ transplants; and persons who are immunosuppressed for other reasons (e.g., taking the equivalent of >15 mg/day of prednisone for 1 month or longer, taking TNF-a antagonists).12 Doubtful Reaction: Induration measuring 5 to 9 mm indicates a doubtful reaction. Retesting is indicated using a different site and 5 TU per test dose. The possibility should not be excluded that the skin sensitivity is due to previous contact with atypical mycobacteria or previous BCG vaccination. Negative Reaction: Induration of less than 5 mm is considered negative.

An individual who does not show a positive reaction to either 1 TU or 5 TU on the first test may be retested with 5 TU and if still found negative further testing with 0.1 mL containing 250 TU of Tuberculin PPD (Mantoux) is suggested. If the latter test is employed, it may be given in the other forearm. An individual who does not show a positive reaction to an initial injection of either 1 TU and 5 TU, or 5 TU alone, and to a subsequent injection of 250 TU of Tuberculin PPD may be considered as tuberculin negative. Booster Effect: Infection of an individual with tubercle bacilli or other mycobacteria results in a delayed hypersensitivity response to tuberculin which is demonstrated by the skin test. The delayed hypersensitivity response may gradually wane over a period of years. If a person receives a tuberculin test at this time (after several years) the response may be a reaction that is not significant. The stimulus of the test may boost or increase the size of the reaction to a second test, sometimes causing an apparent conversion or development of sensitivity.

The booster effect can be seen on a second test done as soon as a week after the initial stimulating test and can persist for a year, and perhaps longer. When routine periodic tuberculin testing of adults is done, two stage testing should be used to minimize the likelihood of interpreting a boosted reaction as a conversion. 7,8 Since a positive tuberculin reaction does not necessarily indicate the presence of active tuberculosis disease, individuals showing a positive tuberculin reaction should be subjected to other diagnostic procedures. Those individuals giving a positive tuberculin reaction may or may not show evidence of tuberculosis disease. Chest X-ray examination and microbiological examination of the sputum in these cases are recommended as a means of determining the presence or absence of pulmonary tuberculosis. How Supplied Tubersol bioequivalent to 5 US units (TU) PPD-S per test dose (0.1 mL) is available in 1 mL and 5 mL vials. Tubersol 1 TU and 250 TU per test dose (0.1 mL) are available in 1 mL vials. Tubersol solutions are ready for immediate use without any further dilution.

STORAGE Tubersol should be stored between 2°C and 8°C (35°F and 46°F). 5,9 Tuberculin solutions can be adversely affected by exposure to light. The product should be stored in the dark except when doses are actually being withdrawn from the vial. 10 A vial of Tuberculin PPD which has been opened and in use for one month should be discarded because oxidation and degradation may have reduced the potency. 11 References Landi, S.: Preparation, purification, and stability of tuberculin. Appl. Microbiol. 11: 408-412. Canadian Tuberculosis and Respiratory Disease Association: Classification and reporting of tuberculosis in Canada. Ottawa, the Association, 1972 p. 42. Landi S., et al.: Adsorption of tuberculin PPD to glass and plastic surfaces. Bull. WHO 1966; 35: 593-602. Landi S., et al.: Disparity of potency between stabilized and nonstabilized dilute tuberculin solutions.

Am Rev Respir Dis 1971; 104: 385-393. Landi, S., et al.: Stability of dilute solutions of tuberculin purified protien derivative. Tubercle 1978; 59: 121-133. US Code of Federal Regulations, Title 21, Part 650, Subpart B--tuberculin, 144-146, April 1, 1981. The Tuberculin Skin Test. Am Rev Respir Dis 1981; 124: 356-363. American Thoracic Society: Diagnostic Standards and Classification of Tuberculosis and Other Mycobacterial Diseases (14th ed.), 1980. Am Rev Respir Dis 1981; 123: 343-358. Landi, S., et al.: Stability of dilute solution of tuberculin purified protein derivative at extreme temperatures. J Biol Stand 1981; 9: 195-199.

Landi, S., et al.: Effect of light on tuberculin purified protein derivative solutions. Am Rev Respir Dis 1975; 111:52-61. Landi, S., et al.: Effect of oxidation on the stability of tuberculin purified protein derivative (PPD) In: International Symposium on Tuberculins and BCG Vaccine. Basel: International Association of Biological Standardization, 1983. (Developments in Biological Standardization) 1986; 58: 545-552. Centers for Disease Control and Prevention - Tuberculin Skin Testing Fact Sheet Accessed April 22, 2015. Manufactured by: Tuberculosis (TB) - Diagnosis - NHS Choices Several tests are used to diagnose tuberculosis (TB), depending on the type of TB suspected. Your GP may refer you to a TB specialist for testing and treatment if they think you have TB. Pulmonary TB Diagnosing pulmonary TB – TB that affects the lungs – can be difficult, and several tests are usually needed. You may have a chest X-ray to look for changes in the appearance of your lungs that are suggestive of TB.

Samples of phlegm will also often be taken and checked for the presence of TB bacteria. These tests are important in helping to decide the most effective treatment for you. Extrapulmonary TB Several tests can be used to confirm a diagnosis of suspected extrapulmonary TB, which is TB that occurs outside the lungs. These tests include: urine and blood tests a biopsy – a small sample of tissue or fluid is taken from the affected area and tested for TB bacteria You may also have a lumbar puncture , where a small sample of cerebrospinal fluid (CSF) is taken from the base of your spine. CSF is fluid that surrounds the brain. The sample can be checked to see whether TB has infected your brain and spinal cord (central nervous system). Testing for latent TB In some circumstances, you may need to have a test to check for latent TB – where you've been infected with TB bacteria, but don't have any symptoms. For example, you may need to have a test if you've been in close contact with someone known to have active TB disease involving the lungs, or if you've recently spent time in a country where TB levels are high.

If you've just moved to the UK from a country where TB is common, you should be given information and advice about the need for testing. Your GP may suggest having a test when you register as a patient. Mantoux test The Mantoux test is a widely used test for latent TB. It involves injecting a small amount of a substance called PPD tuberculin into the skin of your forearm. It's also called the tuberculin skin test (TST). If you have a latent TB infection, your skin will be sensitive to PPD tuberculin and a small, hard red bump will develop at the site of the injection, usually within 48 to 72 hours of having the test. If you have a very strong skin reaction, you may need a chest X-ray to confirm whether you have active TB disease. If you don't have a latent infection, your skin won't react to the Mantoux test. However, as TB can take a long time to develop, you may need to be screened again at a later stage. If you've had the BCG vaccination , you may have a mild skin reaction to the Mantoux test. This doesn't necessarily mean you have latent TB.

Interferon gamma release assay (IGRA) The interferon gamma release assay (IGRA) is a blood test for TB that's becoming more widely available. The IGRA may be used to help diagnose latent TB: if you have a positive Mantoux test if you previously had the BCG vaccination – the Mantoux test may not be reliable in these cases as part of your TB screening if you've just moved to the UK from a country where TB is common as part of a health check when you register with a GP if you're about to have treatment that will suppress your immune system if you're a healthcare worker Page last reviewed: 15/11/2016 TB (Tuberculosis) Skin Test Guide: Causes, Symptoms and Treatment Options TB (Tuberculosis) Skin Test What is the test? Tuberculosis is a bacterial infection that most often involves the lungs, but can involve many other organs. Although antibiotics can treat most cases, TB remains one of the most common causes of death worldwide. The TB skin test, also called the purified protein derivative (PPD) test or Mantoux test, shows if you've ever been infected with the bacteria that cause tuberculosis. Infections with these bacteria can be active or inactive.

In active infections, the bacteria are reproducing rapidly, and the person is contagious when he or she coughs. In people with inactive infections, the bacteria are alive deep within the lungs, but "asleep." Because inactive infections can later "wake up" and become active, it is important to recognize and treat both types of TB infections. How do I prepare for the test? Vaccinations, corticosteroids such as prednisone and other drugs that suppress the immune system such as biologic agents can affect the results of the test. So, tell your doctor if you've recently been vaccinated for an infectious disease or if you're taking a corticosteroid or other immune suppressant. What happens when the test is performed? A doctor injects a small amount of liquid containing protein extracted from killed TB bacteria just under the surface of the skin of your forearm, through a tiny needle. You might feel a slight pinch from the injection, and see a small swollen area form where the liquid has been injected. The doctor often draws a circle around the injection spot and asks you to avoid washing it away. Then, 48-72 hours later, you return to have the injection area examined.

If the skin is firm and raised where the injection was given, the doctor measures the size of the affected area. The larger it is, the greater the likelihood that you have been infected with the TB bacteria at some time in the past, and that you have a current infection. The test cannot distinguish between an inactive and active infection. What risks are there from the test? There are no risks. Must I do anything special after the test is over? Remember to return to have the injection site examined. How long is it before the result of the test is known? The result is known two to three days later when the skin is examined. If the test is positive, your doctor will likely order a chest x-ray. You may also do blood and urine tests. If you do not have an active infection, your doctor will prescribe an antibiotic given over several months, to help prevent you from developing active tuberculosis. If you do have an active infection, a much more intensive treatment involving multiple antibiotics is required. Disclaimer: This content should not be considered complete and should not be used in place of a call or visit to a health professional. Use of this content is subject to specific Terms of Use & Medical Disclaimers .

Learn more about TB (Tuberculosis) Skin Test Drugs associated with:

Question: In medicine, for what would you take a Mantoux Test?
Answer: Tuberculosis